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Workbook
Workbook for
for Lippincott’s
Lippincott’s Textbook
Textbook

for Nursing Assistants

Third Edition

PAMELA J. CARTER, RN, BSN, MEd, CNOR

Program Coordinator/Instructor
School of Health Professions
Davis Applied Technology College
Kaysville, Utah
LWBK743-FM_i-x.qxd 24/11/2010 04:10 AM Page ii Aptara

Acquisitions Editor: Elizabeth Nieginski

Product Manager: Eric Van Osten
Vendor Manager: Cynthia Rudy
Director of Nursing Production: Helen Ewan
Designer: Holly McLaughlin
Manufacturing Coordinator: Karin Duffield
Production Services / Compositor: Aptara, Inc.

3rd edition

Copyright © 2012 by Lippincott Williams & Wilkins, a Wolters Kluwer business.

Copyright © 2008 by Lippincott Williams & Wilkins.

Copyright © 2005 by Lippincott Williams & Wilkins. All rights reserved. This book is protected
by copyright. No part of this book may be reproduced or transmitted in any form or by any
means, including as photocopies or scanned-in or other electronic copies, or utilized by any
information storage and retrieval system without written permission from the copyright owner,
except for brief quotations embodied in critical articles and reviews. Materials appearing in this
book prepared by individuals as part of their official duties as U.S. government employees are not
covered by the above-mentioned copyright. To request permission, please contact Lippincott
Williams & Wilkins at Two Commerce Square, 2001 Market Street, Philadelphia, PA 19103, via
email at [email protected], or via our website at lww.com (products and services).

9 8 7 6 5 4 3 2 1

ISBN-13: 978-1-60547-636-0
ISBN-10: 1-60547-636-6

Care has been taken to confirm the accuracy of the information presented and to describe gener-
ally accepted practices. However, the author, editors, and publisher are not responsible for errors
or omissions or for any consequences from application of the information in this book and
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of the contents of the publication. Application of this information in a particular situation remains
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reader is urged to check the package insert for each drug for any change in indications and
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Some drugs and medical devices presented in this publication have Food and Drug Adminis-
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Preface

Workbook for Lippincott’s Textbook for Nursing ACTIVITIES DESIGNED TO

Assistants, developed alongside the textbook with
the aid of an instructional design team, is
APPEAL TO DIFFERENT TYPES
designed to help students internalize and apply OF LEARNERS
the important concepts and facts presented in
the textbook. Students will benefit from first This workbook uses several different types of
reading the assignment in the textbook and then activities to help students internalize and apply
completing the corresponding workbook assign- the information in the textbook. A wide variety
ment. This approach allows students to review of activities is important for appealing to
and reinforce the information that they have just students with different learning styles. Variety
read. In addition, after working on the workbook also helps to keep students engaged in the
assignment, students who are having difficulty assignment. Some of the activity types that you
understanding the information presented in the will find in this workbook include:
textbook will know what type of questions they ■ Multiple-choice questions: Select the
need to ask in class the following day. This single best answer from four choices.
ability to recognize areas of difficulty helps ■ Fill-in-the-blanks: Complete a phrase or
students to better utilize instruction time. sentence.
■ Think About It! Write a short response to a
thought-provoking “what if?” scenario.
A UNIQUE ORGANIZATION ■ True or false? Identify the true statements
and correct the false ones.
The organization of each chapter in the ■ Matching: Match the terms or pictures to
workbook follows the same organization as the their descriptions.
corresponding chapter in Lippincott’s Textbook for ■ Crossword puzzles: Decipher the clues to
Nursing Assistants. This unique organization complete the puzzle.
enhances flexibility with regard to assignments— ■ Word find puzzles: Locate key vocabulary
it is easy to assign all, or just part of, a workbook words in the grid of letters.
chapter, according to the needs of your particular ■ Word jumbles: Use the clues to rearrange
curriculum. In addition, this unique organization scrambled letters and reveal key vocabulary
allows students to identify particular areas of words.
difficulty where more clarification and review is ■ Labeling: Fill in the missing labels on a key
needed. Key Learning Points, derived from piece of artwork.
the learning objectives in the textbook, are given ■ Sequencing: Put the steps of a procedure or
for each sub-topic within the chapter and help process in the correct order.
the student to easily identify the concepts that ■ Identification: Recognize the phrases or
are being reviewed and reinforced. sentences that apply to each situation.

iii
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iv PREFACE

Many workbooks rely heavily on multiple- the course, when students are practicing the
choice questions. Although multiple-choice procedures they have just learned.
questions are important for helping students to ■ Pam’s pearls: Scattered throughout the
prepare for the certification exam, the goal of workbook, these words of advice and encour-
this workbook is to help prepare students for agement from the author serve to reinforce
what comes after the exam. We want students to key concepts and remind students of the very
develop a depth of understanding of this important role they will play in providing
material that will serve them well in their clinical patient and resident care.
practice, long after the exam is over. Our goal is
to help promote good problem-solving abilities
Preventing the complications of
and more of a “working” application of the
immobility through frequent
material. Instructors wishing to provide their
repositioning and transferring is a major
students with additional practice in answering
responsibility of the nursing assistant!
multiple-choice questions can create worksheets
and practice tests using the multiple-choice
questions provided on the Instructor’s Resource Answers to the activities in the Workbook for
CD and on thePoint, a web-based course and Lippincott’s Textbook for Nursing Assistants are
content management system provided on the Instructor’s Resource CD and on
(http://[email protected]/Carter3e). thePoint (http://[email protected]/Carter3e).
It is our sincere hope that students will find
completing assignments from the workbook to
OTHER KEY FEATURES be fun as well as educational. As always, we
welcome and appreciate feedback from our
In addition to a variety of activities designed to readers.
reinforce the information in Chapters 1 through
45 and Appendix B (“Introduction to the Pamela J. Carter
Language of Health Care”) of Lippincott’s Textbook Lippincott Williams & Wilkins
for Nursing Assistants, this workbook contains:
■ Procedure checklists. These checklists are
very useful during the laboratory portion of

*thePoint is a trademark of WKHealth.

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Acknowledgment

I’d like to thank Joellen Shumway, Elizabeth Nieginski, and Eric Van Osten for their assistance
during the development of this workbook.

v
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LWBK743-FM_i-x.qxd 11/8/10 11:05 AM Page vii Aptara

Contents

CHAPTER 10
UNIT I
Patient Safety and Restraint
INTRODUCTION TO HEALTH CARE Alternatives 50
CHAPTER 1 CHAPTER 11
The Health Care System 1 Positioning, Lifting, and Transferring
Patients and Residents 55
CHAPTER 2
The Nursing Assistant 5 CHAPTER 12
Basic First Aid and Emergency Care 59
CHAPTER 3
Professionalism and
Job-Seeking Skills 9
UNIT III
BASIC PATIENT and RESIDENT CARE
CHAPTER 4
Legal and Ethical Issues 15 CHAPTER 13
The Patient or Resident Environment 65
CHAPTER 5
Communication Skills 20 CHAPTER 14
CHAPTER 6 Admissions, Transfers, and Discharges 71
Those We Care For 25
CHAPTER 15
Bedmaking 74
UNIT II
SAFETY CHAPTER 16
Vital Signs, Height, and Weight 79
CHAPTER 7
Communicable Disease and Infection CHAPTER 17
Control 32 Comfort and Rest 90
CHAPTER 8 CHAPTER 18
Bloodborne and Airborne Pathogens 39 Cleanliness and Hygiene 95
CHAPTER 9 CHAPTER 19
Workplace Safety 43 Grooming 103
vii
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viii CONTENTS

CHAPTER 20 CHAPTER 32
Basic Nutrition 109 The Digestive System 185

CHAPTER 21 CHAPTER 33
Assisting With Urinary The Urinary System 192
and Bowel Elimination 117
CHAPTER 34
UNIT IV The Reproductive System 198

DEATH AND DYING

UNIT VI
CHAPTER 22 SPECIAL CARE CONCERNS
Caring for People
Who Are Terminally Ill 124 CHAPTER 35
Caring for People With
CHAPTER 23 Rehabilitation Needs 206
Caring for People Who Are Dying 127
CHAPTER 36
UNIT V Caring for People With Developmental
Disabilities 210
STRUCTURE AND FUNCTION OF THE
HUMAN BODY CHAPTER 37
CHAPTER 24 Caring for People
With Mental Illness 215
Basic Body Structure and Function 132
CHAPTER 38
CHAPTER 25
Caring for People With Dementia 220
The Integumentary System 137
CHAPTER 39
CHAPTER 26
Caring for People With Cancer 226
The Musculoskeletal System 144
CHAPTER 40
CHAPTER 27
Caring for People With HIV/AIDS 230
The Respiratory System 150

CHAPTER 28 UNIT VII

The Cardiovascular System 160 ACUTE CARE

CHAPTER 29 CHAPTER 41
The Nervous System 169 Caring for Surgical Patients 233

CHAPTER 30 CHAPTER 42
The Sensory System 174 Caring for Mothers and Newborns 239

CHAPTER 31 CHAPTER 43
The Endocrine System 180 Caring for Pediatric Patients 244
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CONTENTS ix

APPENDIX B
UNIT VIII
Introduction to the Language of
HOME HEALTH CARE Health Care 257
CHAPTER 44 Procedure Checklist 265
Introduction to Home Health Care 249

CHAPTER 45
Safety and Infection Control
in the Home Health Care Setting 253
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CHAPTER
The Health Care
System

HEALTH CARE DELIVERY, c. To train people in the field of health care

PAST AND PRESENT d. To teach people the ways to achieve and
maintain physical and mental fitness
Key Learning Points 2. Who is referred to as a “patient”?
■ The changes that have occurred in how health a. A person who receives the services of a
care is delivered long-term care facility
b. A person who receives the services of an
Activity A Mark each statement as either
assisted-living facility
“true” (T) or “false” (F). Correct the false
statements. c. A person who receives the services of a hospital
d. A person who receives the services of a
1. T F In the 18th, 19th, and early part of the
home health care agency
20th centuries, health care delivery in
the United States was focused around 3. Why are people who are cared for in a long-
care given in health care facilities. term care facility referred to as “residents”
rather than “patients”?
2. T F A holistic approach focuses on taking care
of only the emotional needs of a person. a. Because most of the people who are admit-
ted to a long-term care facility are elderly
b. Because the long-term care facility
becomes the person’s home, either
HEALTH CARE ORGANIZATIONS temporarily or permanently
Key Learning Points c. Because the long-term care facility cares for
people of all ages with any number of
■ Types of health care organizations different medical needs
■ Structure of a health care organization
d. Because the people in a long-term care
Activity B Select the single best answer for facility receive more advanced care than
each of the following questions. those in a hospital

1. Which of the following would most likely be Activity C Fill in the blanks using the words
the primary mission of a university hospital? given in brackets.
a. To use the health care industry as a
[inpatient, outpatient]
financial investment to turn a profit
b. To promote health by offering 1. A patient who stays in a hospital for one or
rehabilitation services to people more nights receives care.

1
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2 UNIT 1 INTRODUCTION TO HEALTH CARE

2. A patient with cancer who returns to the hos- 4. Long-term b. Provides limited
pital every day for a period of time to receive care facility help with
radiation therapy would be receiving medications,
5. Subacute care
care. transportation,
unit
meals, and
Activity D Observe the figure and answer the housekeeping
following question. c. Provides care for
people who are
Physical therapist unable to care for
themselves at
Lab, Housekeeping
home yet do not
pharmacy, need to be hospital-
X-ray ized
d. Provides skilled care
Social Dietary in a person’s home
services
e. Relieves pain and
provides emotional
Patient or resident and spiritual
support for both the
dying person and
the family
Physician Nursing
assistant
Activity F Look at the organization chart
Nurse below and match the job title in Column A
with its corresponding function in Column B.
1. In a health care setting, who is always the
focus of the health care team’s efforts?
Board of Trustees
a. The physician
b. The housekeeping staff
c. The patient or resident
d. Social services
Administrator CEO Medical staff

Health care is provided by a team of

people, each with different areas of
expertise and job responsibilities. As a nursing
assistant, you are a critical member of the Director of Director of Director of Director of
Nursing Ancillary Business Facility
health care team!
Services Services

Activity E Match the health care organization

in Column A with its corresponding function in RNs X-ray Admitting Housekeeping
Column B. Lab Billing Maintenance
LPNs Pharmacy Collections Security
Column A Column B Dietary Payroll Laundry
CNAs
1. Hospice a. Provides rehabilita- Human Grounds
Resources
tion and other
2. Home health
skilled care and
care
helps the person
3. Assisted-living advance from
facility hospital care to
home care

Copyright © 2012. Wolters Kluwer Health | Lippincott Williams & Wilkins. Workbook for Lippincott’s Textbook for Nursing Assistants,
A Humanistic Approach to Caregiving, 3rd edition.
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CHAPTER 1 THE HEALTH CARE SYSTEM 3

Column A Column B PAYING FOR HEALTH CARE

1. Board of a. Manages the organi-
trustees zation and is the Key Learning Points
link between the ■ How health care is paid for
2. Director of
board and the
Nursing
organization Activity H Match the insurance or plan in
3. Administrator b. Sets policies to Column A with its corresponding function in
or chief exec- ensure that the care Column B.
utive officer offered by the orga- Column A Column B
nization is safe and
of good quality 1. Group a. A federally funded
insurance insurance plan by
c. Responsible for the
Social Security,
quality of the nurs- 2. Managed care
under the adminis-
ing care provided in system
tration of the Cen-
the facility
3. Medicare ter for Medicare and
Medicaid Services
4. Medicaid
(CMMS)
OVERSIGHT OF THE b. A federally funded
HEALTH CARE SYSTEM and state-regulated
plan designed to
Key Learning Points help people with
■ Government and private agencies that provide low incomes to pay
oversight of the health care system for health care
c. Insurance that is
Activity G Match the agencies and regulations purchased at
used to protect health care recipients and group rates by an
providers in Column A with their corresponding employer or
function in Column B. corporation
Column A Column B d. Assists in delivering
health care to peo-
1. United States a. Established safety ple who need it by
Department and health standards arranging contacts
of Health and for the workplace with various health
Human Services b. Sets national care providers
2. Omnibus Budget standards for all
Reconciliation types of health care
Act (OBRA), 1987 organizations
c. Primary government
3. Occupational
agency responsible
Safety and Health
for protecting
Act, 1970
nation’s health
4. The Joint d. Improved
Commission conditions for
people in long-term
care facilities

Copyright © 2012. Wolters Kluwer Health | Lippincott Williams & Wilkins. Workbook for Lippincott’s Textbook for Nursing Assistants,
A Humanistic Approach to Caregiving, 3rd edition.
LWBK743-Ch01_01-04.qxd 11/09/2010 9:26 PM Page 4 Aptara

M I S S I O N P L
SUMMARY
Activity I Use the clues to find words that are
E Q A Z W S X C G present in the grid of letters, either horizontally
from left to right or vertically from top to
D E C D F P B L R bottom.
I P L H H A H I J Down
1. A type of insurance plan that is federally
C K L O I T U E K funded by Social Security and that all people
65 years and older, and some younger
A W B L K I Q N L disabled people, are eligible to participate in
2. An adjective used to describe care of
R E S I D E N T V the whole person, physically and emotionally
3. A federally funded and state-regulated plan
E U H S Q N D Y X designed to help people with low incomes to
pay for health care
W K M T S T F H M
Across
E Q A I F A M N A 1. The officially stated purpose of a health care
facility or organization
R W Y C L I E N T 2. A person being cared for in a long-term care
facility
T B T F U H D U Q 3. A person who is receiving the services of a
home health care agency
Y I J N K M I J W

U X D W Q A C M F

I U H B T F A C S

O K M I J N I B A

P Q A X D W D X Y
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CHAPTER
The Nursing Assistant

NURSING, PAST AND PRESENT c. Omnibus Budget Revision Act

d. Omnibus Budget Reform Act
Key Learning Points 2. OBRA requires that every state maintain an
■ The history of nursing official database of the people who have
successfully completed the nursing assistant
Activity A Select the single best answer for training program. What is this record called?
each of the following questions.
a. A catalogue
1. What is Florence Nightingale credited for? b. A database
a. Demonstrating the effect of music on the sick c. A handbook
b. Establishing nursing as a profession in its d. A registry
own right
c. Founding the world’s first hospital Activity C Mark each statement as either
d. Discovering the cure for smallpox “true” (T) or “false” (F). Correct the false
statements.
2. What were early nursing assistants called?
1. T F Many long-term care facilities offer nurs-
a. Helpers
ing assistant training programs.
b. Sub-nurses
2. T F OBRA requires all nursing assistants to
c. Aides
undergo a minimum of 50 hours of
d. Caretakers training.
3. T F A student is given three opportunities to
successfully complete the competency
EDUCATION OF THE evaluation at the end of the training
NURSING ASSISTANT period.
4. T F The principle of reciprocity means that
Key Learning Points your certificate will not be valid in states
■ OBRA requirements for nursing assistant other than where you received your
training training.
■ Contents of the registry
5. T F Nursing assistants who have not worked
Activity B Select the single best answer for for 2 consecutive years need to undergo
each of the following questions. retraining and retake the competency
evaluation.
1. What does OBRA stand for?
a. Overall Budget Reconciliation Act
b. Omnibus Budget Reconciliation Act

5
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6 UNIT 1 INTRODUCTION TO HEALTH CARE

Activity D Place an “X” next to the THE NURSING TEAM

information that does NOT appear in the
registry. Key Learning Points
1. Full name ■ The members of the nursing team, and the
role of each team member
2. Home address
3. Social Security number Activity F Fill in the blanks.

4. Date of birth 1. Every nursing team consists of at least a nurse

and a nursing assistant. A nurse
5. Date the competency evaluation was can either be a
passed , or a .
6. Educational qualifications In some states, an LPN is also referred to as a
.
7. Reported incidents of resident A nursing team could also include
abuse or neglect, or theft of resident a , whose duty
property involves supervising other nurses during a
shift, and a , who
heads a department or section. An RN who
RESPONSIBILITIES OF directs all the nursing care within a health
care organization is called a
THE NURSING ASSISTANT .
Key Learning Points Activity G Think About It! Briefly answer
■ Responsibilities of the nursing assistant the following question in the space provided.

Activity E Select the single best answer for Explain the difference between primary
each of the following questions. nursing, functional (modular) nursing, and team
nursing.
1. What important role does the nursing
assistant play?
a. Consultant
b. Medical advisor
c. Observer and communicator
d. Administrator
2. Which one of the following is NOT a basic DELEGATION
physical need?
Key Learning Points
a. Hygiene
■ The delegation process as it relates to the nurs-
b. Comfort ing assistant
c. Nutrition ■ The “five rights” of delegation
d. Entertainment
3. A nursing assistant’s duties do NOT include
taking care of the patient’s or resident’s:
a. Safety
b. Exercise
c. Financial needs
d. Emotional needs

Copyright © 2012. Wolters Kluwer Health | Lippincott Williams & Wilkins. Workbook for Lippincott’s Textbook for Nursing Assistants,
A Humanistic Approach to Caregiving, 3rd edition.
LWBK743-Ch02_05-08.qxd 11/09/2010 9:28 PM Page 7 Aptara

CHAPTER 2 THE NURSING ASSISTANT 7

Activity H Mark each statement as either Activity J Select the single best answer for
“true” (T) or “false” (F). Correct the false each of the following questions.
statements.
1. Which one of the following reasons is NOT an
1. T F “Scope of practice” refers to the range of acceptable reason to refuse to perform a dele-
tasks that a nursing assistant is morally gated task?
allowed to perform. a. The directions given to you by the nurse are
2. T F By delegating a task, a nurse gives not clear.
a nursing assistant permission to b. You do not have the proper equipment to
perform the task on his or her behalf. perform the task.
3. T F Tasks such as assessment, planning, and c. You do not enjoy the task.
evaluating can be delegated to nursing d. The task is illegal or unethical.
assistants. 2. When a nurse delegates a task to a nursing
assistant, the nurse is responsible for any
Activity I The National Council of State
injury that may occur to the patient or
Boards of Nursing (NCSBN) has developed resident if:
guidelines, called the “five rights” of delegation,
to help nurses effectively delegate tasks. Match a. The nursing assistant is not qualified for the
the rights in Column A with the corresponding task
guidelines in Column B. b. The nursing assistant is suitably qualified,
but is not supervised by the nurse
Column A Column B
c. The nursing assistant is suitably qualified
1. The right task a. Will the nurse but makes a mistake while carrying out the
be available to task
2. The right
supervise or answer
circumstance d. The nursing assistant is suitably qualified
questions?
but does not perform the task as requested
3. The right b. Will the nurse be
person able to give the
nursing assistant The delegation of tasks cannot be taken
4. The right
clear directions lightly by either the nurse or the nursing
direction
regarding how to assistant. Both share responsibility for
5. The right perform the task? ensuring that the procedure is carried out
supervision without harm to the patient or resident.
c. What are the needs
Know which tasks are within your scope of
of the patient or resi-
practice and which are not, and don’t be
dent at this time?
afraid to ask for help or clarification if you
d. Can this task be need it.
delegated?
e. Does the nursing
assistant have
the right training
and experience to
safely complete the
task?

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8 UNIT 1 INTRODUCTION TO HEALTH CARE

SUMMARY
E R C R I O P T I Y C Activity K Words shown in the picture have
been jumbled. Use the clues to form correct
words using the letters given in the picture.
E G Y R R T I S
1. The principle by which one state recognizes
the validity of a license or certification granted
by another state
E T A G E L E D 2. An official record maintained by the state of
the people who have successfully completed
the nursing assistant training program
A D E H E U R N S 3. To authorize another person to perform a task
on your behalf
4. A registered nurse (RN) who is in charge of a
department or section
A E M T G I N S R U N
5. A model for organizing the nursing team’s
efforts in which a team leader (a registered
nurse) determines all of the nursing needs for
the patients or residents assigned to the team,
and assigns tasks according to each team
member’s skills and level of responsibility

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CHAPTER
Professionalism and
Job-Seeking Skills

WHAT IS A PROFESSIONAL? The health care industry relies on all

types of professionals to provide quality
Key Learning Points care to patients and residents. Professionals
■ The meaning of the terms professional and pro- have certain credentials that are earned
fessionalism through education and training, but being a
■ Characteristics of a professional health care professional also means having a professional
worker attitude and a good work ethic.

Activity A Select the single best answer for the

following question.
1. Which one of the following nursing assistants
WHAT IS A WORK ETHIC?
does NOT show the attitudes characteristic of
a professional? Key Learning Points
a. Sara is an experienced nursing assistant ■ The term work ethic and how good work habits
who is kind and caring toward the patients promote professionalism
and residents in the facility where she
works. Activity B Select the single best answer for
each of the following questions.
b. Sally is a certified nursing assistant who
works only to earn a paycheck. 1. A strong “work ethic” is one of the most
c. Sara is a certified nursing assistant who is important qualities that potential employers
committed to doing her work to the best of look for in a nursing assistant. What does this
her ability. term refer to?
d. Sally is a certified nursing assistant who takes a. A person’s ability to judge whether a nurse
pride in her work at the hospital and is has made a correct decision
always interested in learning more about b. A person’s ability to perform the work
her job. assigned to him or her
c. A person’s attitude toward his or her work
d. A person’s awareness of the rules that
should be followed in the workplace

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10 UNIT 1 INTRODUCTION TO HEALTH CARE

2. Which of the following qualities does NOT PERSONAL HEALTH AND

reflect a strong work ethic?
HYGIENE
a. Punctuality
b. Competitiveness Key Learning Points
c. Accountability ■ The importance of personal health and
d. Reliability hygiene for a health care worker

Activity C Match the words given in Activity D To maintain good physical health,
Column A with the corresponding meanings a nursing assistant must take care of himself or
in Column B. herself first. Look at the figures below and fill in
the blanks.
Column A Column B
1. Punctuality a. You can be trusted B
A
by patients and
2. Reliability
residents with
3. Accountability their private
information and
4. Conscientious-
valuables.
ness
b. You are polite and
5. Courtesy and C
do not make nega-
respectfulness tive remarks about
your coworkers. D
6. Honesty
c. Your supervisor can
7. Cooperative-
depend on you to
ness
finish your assign-
8. Empathy ment properly.
d. You offer a helping
hand when you
see that a coworker
requires help.
e. You take responsi-
bility for your
actions and their
consequences.
f. You are always on
time for work.
g. You are able to
show kindness and
tolerance by imag-
ining yourself in E
someone else’s
situation. A. You should get enough .
h. You take your
B. You should not and you
work seriously and
should limit your intake.
give your patients
or residents the C. You should regularly.
“royal treatment.”
D. You should have a routine
.
A nursing assistant with a strong work E. You should eat __________________________
ethic has qualities that make her both meals.
pleasant to work with and dependable.

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CHAPTER 3 PROFESSIONALISM AND JOB-SEEKING SKILLS 11

Activity E Select the single best answer for Activity G Match the characteristics of a
each of the following questions. nursing assistant in Column A with the health
care facility that she would be best suited for in
1. Why is it important for a nursing assistant to
Column B.
maintain good personal hygiene?
a. Good personal hygiene helps to prevent the Column A Column B
spread of infection. 1. Likes to work a. acute care unit
b. Good personal hygiene sets you apart from with elderly b. long-term care
other nursing assistants. people facility
c. Good personal hygiene makes you eligible 2. Wants to care c. home health
for a raise in salary. for people in care agency
d. Good personal hygiene sets an example for their homes
your patients and residents.
3. Likes a fast-
2. Which of the following activities is NOT a paced work
part of maintaining good personal environment
hygiene?
a. Bathing daily and using a deodorant Activity H Sally is searching for a suitable
nursing assistant job. Considering her
b. Keeping your nails short and clean
situation, help her make a decision from the
c. Wearing a clean, pressed uniform everyday given options. Select the single best answer for
d. Wearing jewelry to improve your appearance each of the following situations.
1. Sally has a child.
Activity F Mark each statement as either
“true” (T) or “false” (F). Correct the false
statements.
1. T F Physical activity relieves mental and
emotional stress.
2. T F Making time for yourself is just not that
important when you feel overwhelmed
with responsibilities.
3. T F You must never ask to be assigned to dif-
ferent work areas or to different patients
or residents.

To care for your patients or residents to

the best of your ability, you must first
care for yourself!

JOB-SEEKING SKILLS
a. She takes the child to work.
Key Learning Points b. She works whatever shift she is scheduled
■ Sources of information about employment for, not considering the childcare
opportunities in the health care industry arrangements.
■ Factors to consider when seeking employment c. She tells the employer that she is available to
■ The application process necessary for work any shift, even though this is not true.
obtaining employment d. She tells the employer what shift she is
available to work, based on her childcare
arrangements.

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12 UNIT 1 INTRODUCTION TO HEALTH CARE

2. Sally plans to take the bus to get to work. Activity I Use the clues for sources of
employment opportunities to complete the
crossword puzzle.
2nd Avenue
1

2 3

a. She applies for a job at every health care 6

facility, whether or not it is served by the
bus line nearest to her home.
b. She applies for a job at health care facilities
serviced by the bus line nearest her home.
c. She applies for a job at a health care facil-
ity serviced by the train, even though she
does not live near a train station.
d. She applies for a job at every health care
facility, even those not served by public
transportation.

Across
4. Contains classified ads listing employment
opportunities
6. Use this to check sites that help people find
jobs
Down
1. A department at your school that may have
job listings and can often help with writing a
résumé

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CHAPTER 3 PROFESSIONALISM AND JOB-SEEKING SKILLS 13

2. Check here for a list of facilities and agencies Activity L Think About It! Briefly answer the
that hire nursing assistants following question in the space provided.
3. They may know of possible job openings
5. Many schools and facilities have one of these, Amy Robinson goes on an interview for a posi-
where job opportunities may be posted tion as a nursing assistant at a long-term care fa-
cility. The interviewer asks Amy whether or not
she is married. How should Amy respond to the
Advance planning about the type of interviewer’s question?
employment you want helps to give your
job search direction.

Activity J Match the words given in

Column A with their corresponding meanings
in Column B. Activity M Select the single best answer for the
following question.
Column A Column B
1. Why is it a good idea to first ask for a person’s
1. Résumé a. A letter to introduce permission before including his name
yourself to a and contact information in your reference list?
2. Cover letter
potential employer
a. The person may not want his contact
3. Reference list b. List of three or four information given out.
people willing to
b. The person may not be able to give you a
talk to a potential
positive reference and therefore might be
employer about your
more comfortable not giving any reference
abilities
at all.
c. A brief document that
c. It is good manners to ask before including
gives general informa-
someone on a reference list.
tion about you, your
education, and work d. All of the above
experience to a poten-
tial employer Activity N Place an “X” next to the
information that should be included in a job
Activity K Place an “X” next to the application form.
information that should be included in a 1. Weight
résumé.
2. Work history
1. Full name
3. Marital status
2. Employment history
4. Education
3. Weight
5. Position applied for
4. Marital status
6. Reason you left your previous job
5. Age
7. Shifts that you can work
6. Address
8. Contact address and how can you be
7. Education history reached
8. Sexual preference 9. Sexual preference
10. Religion

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14 UNIT 1 INTRODUCTION TO HEALTH CARE

Activity O Which one of the nursing 2. A person who has credentials, obtained
assistants pictured below is most likely to make through education and training, that enable
a favorable impression on a potential employer? him or her to become licensed or certified to
practice a certain profession; also, a person
who demonstrates a professional attitude
A. B. 3. The side of ourselves that we display to the
world, communicating outwardly how we feel
about things
4. A brief document that gives a potential
employer general information about a job
candidate’s education and work
experience
Across
1. A person’s attitude toward his or her work
C. D.

I H R P E R S O N

N L I S T S D Y J

T A E N Y B G P Q

E V S E T L K I D

Activity P Fill in the blanks.

R A Z W P L I V B
1. If you haven’t heard from your employer in V L M R R A E A W
week’s time, it is appropriate
to call and ask about the status of your I J Q L O V S T T
application.
2. Write a thank you note within
E T O D F O N T U
day(s) of interviewing for a position.
W O R K E T H I C

R S E Q S V R T I
SUMMARY
F A S A S A I U T
Activity Q Use the clues to find words that are
present in the grid of letters, either horizontally V D U Z I L E D R
from left to right or vertically from top to
bottom. Y Y M W O J S E U
Down
A G E S N T Z A S
1. A meeting between an employer and a poten-
tial employee, during which information is S N Q X A R M E R
exchanged regarding the organization, the
job, and the potential employee’s H F T T L Y Q Y D
qualifications for the job

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CHAPTER
Legal and Ethical Issues

INTRODUCTION TO LEGAL PATIENTS’ AND RESIDENTS’

AND ETHICAL ISSUES RIGHTS
Key Learning Points Key Learning Points
■ Factors influencing behavior in society ■ Patients’ and residents’ rights, as set forth by
■ Need for laws and ethics the American Hospital Association (AHA) and
the Omnibus Budget Reconciliation Act (OBRA)
Activity A Place an “X” next to the ■ Two major types of advance directives
factors that influence a person’s behavior ■ Why advance directives play an important role
in society. in health care
1. Society’s laws
Activity C Select the single best answer for
2. Personal ethical code each of the following questions.
3. Fear of punishment 1. Which of the following statements is NOT
listed in The Patient Care Partnership?
4. Spiritual beliefs
a. The right to information regarding diagno-
5. Values instilled by family sis, treatment, and prognosis
6. Rules established by a governing b. The right of confidentiality pertaining to all
authority communication
c. The right to use personal possessions
Activity B Mark each statement as either
d. The right to considerate and respectful care
“true” (T) or “false” (F). Correct the false
statements. 2. Where is the right to be informed of one’s
options for care stated?
1. T F Fear of punishment is what causes a
person to act according to an ethical a. The Patient Care Partnership
code. b. Patients’ Bill of Responsibilities
2. T F Laws and ethics provide guidance to c. Residents’ Rights
health care providers. d. Rights for the Health Care Organizations
3. T F Values instilled by a person’s family
influence the person’s ethical code.

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16 UNIT 1 INTRODUCTION TO HEALTH CARE

3. Which one of the following is a responsibility 4. A for

of the patient? health care transfers the responsibility for
a. The patient is responsible for the making medical decisions on the person's
consequences of refused treatment or dis- behalf to a family member, friend, or other
regarded instructions. trusted individual, in the event that the
person is no longer able to make these
b. The patient is responsible for withholding
decisions on her own behalf.
information that is confidential.
c. The patient is responsible for having his
medical records explained and interpreted.
d. The patient is responsible for participating
LAWS: A WAY OF PRESERVING
in experimental studies. PATIENTS’ AND RESIDENTS’
4. Which of the following statements is NOT
RIGHTS
listed in the “Residents’ Rights”?
Key Learning Points
a. The right to be free from physical or
■ The legal aspects of health care delivery
psychological abuse, including the
■ Common legal violations that are related to
improper use of restraints
the provision of health care
b. The right to organize and participate in ■ The awareness that health care workers must
groups organized by other residents, or the have in order to avoid legal dilemmas
families of residents ■ Types of abuse and signs that indicate abuse
c. The right to respect the property, comfort, ■ The health care worker’s obligations in the
environment, and privacy of other patients reporting of suspected abuse
d. The right to information about advocacy
groups Activity E Place an “X” next to the correct
answers for the following questions.
5. Which of the following conditions could
result in a loss of the resident’s right to remain 1. Why should laws be enforced?
in the facility? Because they preserve citizens’ basic
a. Planned changes in living arrangements human rights
b. Harrassing or threatening the safety of Because American colonies have gained
other residents independence
c. Participation in social or religious activity
Because they protect basic human rights
d. Sharing the room with a spouse for all people, regardless of race, religion,
gender, or income
Activity D Fill in the blanks using the words
given in brackets. Because they help settle disputes in a civi-
lized, orderly way
[durable power of attorney, advance directive,
living, health care agent] 2. Which of these terms relate to a violation of
civil law?
1. An is a document
that allows a person to make his wishes Litigation
regarding health care known to family Defamation
members and health care workers, in case the
time comes when he is no longer able to make False imprisonment
those wishes known himself. Battery
2. A is 3. What is the purpose of the Health Insurance
the person who is responsible for making deci- Portability and Accountability Act (HIPAA)?
sions on the person's behalf.
It regulates who has the right to view a
3. A will allows the person to give person’s medical records, data, or other
instructions about what medical treatments he private information.
would or would not want to be done in an
effort to save his life.

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CHAPTER 4 LEGAL AND ETHICAL ISSUES 17

It sets standards on how a person’s Activity G Think About It! Briefly answer
medical information is to be stored and the following question in the space provided.
transmitted from one place to another.
Janine works in a long-term care facility located
It permits a contractual agreement that in a small town. One day, Janine runs into Mrs.
exists between a nursing assistant and the Jamison at the grocery store. Janine has just
person he or she cares for. learned that Mrs. Jamison’s mother-in-law, a
It requires that health care organizations resident at the long-term care facility where she
set policies that allow a patient or resident works, has been diagnosed with cancer. Assum-
to have access to his or her medical ing that Mrs. Jamison knows about her mother-
records. in-law’s condition, Janine tells her how sorry she
was to hear the news about her mother-in-law’s
4. Which of the following may be considered cancer. . . . and is stunned when Mrs. Jamison
elder abuse? says, “What cancer?” Did Janine do anything
Larceny wrong by expressing her condolences to Mrs.
Jamison?
Sexual abuse
Involuntary confinement or seclusion
Failure to provide food, water, care, and
medications
5. Which of the following situations may result
in abuse?
A desire of one person to overpower and
dominate another
A primary caregiver becoming very tired,
frustrated, and overwhelmed by the
responsibilities of providing care
A relationship that is long term rather
than short term
A patient or resident who is “difficult” to
manage
A failure to provide medication Activity H Match the terms associated with
abuse or legal issues given in Column A with
Activity F Mark each statement as either their examples given in Column B.
“true” (T) or “false” (F). Correct the false
statements. Column A Column B

1. T F Criminal laws are concerned with the 1. Assault a. A home health aide fails
relationship between the individual and to change an incontinent
2. Fraud
society as a whole. client’s soiled sheets more
3. Neglect than once a week.
2. T F Libel is an untrue oral statement that
4. Slander b. A nursing assistant tells a
hurts another person’s reputation. potential employer that
3. T F Keeping a person in a room alone with 5. Libel he passed his certification
the door closed can be considered a form exam when in fact he
of physical abuse. has not.
c. A nursing assistant
tells Mrs. Smith that if she
can’t be nice to her room-
mate, she will slap her.

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18 UNIT 1 INTRODUCTION TO HEALTH CARE

d. A movie star sues a tabloid 3. is respecting a person’s rights

newspaper that publishes and personal preferences.
an untrue report that the
4. is acting with integrity to earn
movie star had sought
others’ trust.
and received treatment at
a certain well-known 5. is treating people fairly and
mental health clinic. equally, regardless of race,
e. A nurse who feels she has religion, culture, disability, or
been unfairly treated by a ability to pay.
doctor on staff is
overheard telling another Activity J Place an “X” next to statements
employee of the hospital that describe the term “ethics.”
that the doctor never 1. Ethics are less prescriptive than laws.
actually graduated from
medical school. 2. Ethics are moral principles or standards
that govern conduct.

Always keep in mind the legal 3. Ethics are guidelines pertaining to

responsibilities and obligations that you standards of conduct and practice.
have as a caregiver. Knowing the tasks that 5. Ethics help us to determine the difference
are part of your job description and being between right and wrong in areas where
aware of your employer’s policies are critical the law fears to tread.
to ensure that the care you give is within the
legal limits of your job. Activity K Select the single best answer for
each of the following questions.
1. Which act or association provides the
guidelines for the code of ethics for
ETHICS: GUIDELINES FOR nursing?
BEHAVIOR a. American Hospital Association (AHA)
b. Omnibus Budget Reconciliation Act (OBRA)
Key Learning Points
c. Health Insurance Portability and
■ The difference between legal and ethical
Accountability Act (HIPAA)
issues
■ The ethical standards that govern the nursing d. American Nurses Association (ANA)
profession in particular and the health care 2. Which factors influence a person’s values?
profession in general
a. His culture and heritage
Activity I Fill in the blanks using the words b. His illness or disability
given in brackets. c. His income
[Beneficence, Autonomy, Justice, Nonmaleficence, d. His gender
Fidelity]
1. is when kindness and gentleness
are used while administering care.
2. is doing good for patients and res-
idents by preventing harm and
promoting the health and welfare
of the person above all else.

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CHAPTER 4 LEGAL AND ETHICAL ISSUES 19

SUMMARY 1. A violation of civil law

2. Spoken statements that injure someone’s rep-
Words shown in the picture have been jumbled. utation; a form of defamation
Use the clues to form correct words using the 3. Negligence committed by people who hold
letters given in the picture. licenses to practice their profession, such as
doctors, nurses, lawyers, dentists, and pharma-
cists
4. The responsibility of an individual to act
within the confines of the law
R T T O
5. Threatening or attempting to touch a person
without the person’s consent
6. Written statement that injures someone’s rep-
A R E S D N L utation; a form of defamation

A T I C E C A P R M L

L B Y T I L I A I

S A S A L U T

L B I L E

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CHAPTER
Communication Skills

WHAT IS COMMUNICATION? Activity B Select the single best answer for

each of the following questions.
Key Learning Points 1. Which of the following activities is a form of
■ The definition of the word communication communication?
■ Two major forms of communication a. Telling someone something

Activity A Communication is the exchange b. Giving a gift to someone

of information. Conversation is a form of c. Accepting a gift from someone
communication. Look at the following picture d. Driving down to a friend’s house to meet him
and fill in the blanks.
2. Which of the following is an example of
verbal communication?
a. Unintentional facial expressions
b. Shaking the hand of a new patient or
Method of transmission: resident
telephone, talking, etc.
c. Sign language or writing out a question to a
deaf resident
d. Body language
3. Which of the following statements indicates
that Mrs. Smith is using a form of nonverbal
communication?
a. Mrs. Smith walks over to the room next to
hers to talk to another resident.
The is the person with information b. Mrs. Smith grimaces and groans softly
to share, and the is the person when she gets up from her bed and
for whom the information is intended. The attempts to stand.
delivers the information in the c. Mrs. Smith talks about a pain in her back to
form of a which the receiver may a nursing assistant.
or may not understand. Through , d. Mrs. Smith listens carefully to the doctor
or a return message, the lets the who is informing her about her condition.
know whether the message was
received and understood.

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CHAPTER 5 COMMUNICATION SKILLS 21

Activity C Place a “V” next to the statements c. Speak clearly and in a voice that is loud
that are examples of verbal communication, enough to be heard
and an “N” next to the statements that are d. All of the above
examples of nonverbal communication.
2. Which one of the following is an example of
1. Use of language, either spoken or written negative body language?
2. Gently touching a patient or a resident on a. Nodding encouragingly as someone speaks
the shoulder to reassure her b. Crossing your arms across your chest
3. Making a face when you put weight on a c. Making eye contact when speaking to
painful leg someone
d. Gently touching a patient or resident on
4. Using sign language to communicate with
the shoulder or holding her hand
a person who is deaf
3. Which one of the following is an open-
5. Making a telephone call
ended question?
6. Nodding as someone speaks a. “Mr. John, tell me all about a favorite meal
7. Tapping your fingers on the table because you enjoyed in your younger days.”
you are bored b. “Are you Mrs. Smith?”
8. Recording vital sign measurements in a c. “Are you feeling okay, Mrs. Broan?”
patient’s or resident’s chart d. “Don’t you like green beans, Mrs. Jones?”
4. Mr. Zimmer is a new resident at the facility
Nursing assistants are an important link where you work. You have just explained to
between the patient or resident and him how to use the call light control system.
other members of the health care team. The What would be the best thing to say to
nursing assistant is often the first member of Mr. Zimmer to verify that he understands
the health care team to become aware of a what you have just explained to him?
change in a patient’s or resident’s condition a. “Let me make sure you understand this
that could be a sign of something serious. This correctly.”
is why it is important for nursing assistants to
b. “Let me know if you have any questions.”
have good communication skills.
c. “Could you just repeat these instructions
back to me so I can make sure that I
didn’t leave anything out?”
COMMUNICATING EFFECTIVELY d. “Do you think you’ve got it now?”
5. Which of the following is a block to effective
Key Learning Points communication?
■ Techniques that promote effective communi- a. Not being an active listener
cation b. Being judgmental
■ Blocks to effective communication and meth-
c. Interrupting a person before he finishes
ods used to avoid them
speaking
■ Causes of conflict, and ways of resolving
conflicts d. All of the above
6. Conflict between people can occur when one
Activity D Select the single best answer for person:
each of the following questions. a. Is unable to understand or accept another’s
1. How will you create a verbal message as a ideas or beliefs
sender? b. Has expectations that differ from those of
a. Organize relevant facts into a clear the other person
statement c. Misunderstands another person’s words or
b. Use language that the receiver under- intentions
stands d. All of the above

Copyright © 2012. Wolters Kluwer Health | Lippincott Williams & Wilkins. Workbook for Lippincott’s Textbook for Nursing Assistants,
A Humanistic Approach to Caregiving, 3rd edition.
LWBK743-Ch05_20-24.qxd 11/8/10 9:31 AM Page 22 Aptara

22 UNIT 1 INTRODUCTION TO HEALTH CARE

Activity E There are different effective ways to COMMUNICATION AMONG

resolve a conflict. Place “T” in front of the MEMBERS OF THE HEALTH
sentences that describe effective ways of resolving
conflict. Place an “F” next to statements that CARE TEAM
describe ineffective ways of resolving conflict.
Then, correct the statements marked “F.” Key Learning Points
■ Methods of reporting and recording informa-
1. Arrange to speak privately with the tion in a health care setting
person you have a conflict with. ■ How a patient’s or resident’s medical record
2. Ask a supervisor to mediate immediately. makes communication easier among members
of the health care team
3. During the conversation, focus on the
■ Communication technologies that are being
area of conflict.
used in the health care field today
4. Be specific about what you understand ■ Why the nursing assistant is a vital link in the
the problem to be. communication chain
■ How the nursing assistant communicates
5. Tell the person how you feel about him or
information to other members of the health
her.
care team
6. Say, “You really hurt my feelings by what ■ Steps of the nursing process and how the nurs-
you said the other day.” ing team uses the nursing process to plan the
7. Agree to disagree. patient’s or resident’s care
■ Role of effective communication in the provi-
8. Offer advice to the person. sion of quality health care

Activity G Select the single best answer for the

Listening is one of the most important
following question.
communication skills, especially in the
health care field. 1. What usually forms the basis for a subjective
observation?
a. Mrs. Smith, a patient at the hospital, com-
plains of abdominal pain immediately after
TELEPHONE COMMUNICATION a meal.
b. A nursing assistant records Mrs. Smith’s
Key Learning Points temperature.
■ Proper telephone communication skills c. A nursing assistant measures Mrs. Smith’s
urine output.
Activity F Select the single best answer for the d. A nursing assistant reports Mrs. Smith’s
following question. pulse rate to the nurse.
1. As a nursing assistant, you are responsible for
answering the telephone, either at the nurs- Activity H As a nursing assistant, you must be
ing station or in a patient’s or resident’s a good communicator. What will you use your
room. When answering the telephone, what communication skills for? Place an “X” next to
should you NOT do? the relevant statements.
a. Speak in a pleasant and unhurried voice. 1. To comfort, reassure, and teach your
b. Take a message by writing down the caller’s patient or resident
name and telephone number and 2. To achieve a greater understanding of
delivering the message to the person it is what your patients or residents are feeling
intended for. and thinking
c. Convey a kind and professional attitude.
3. To diagnose and treat medical problems
d. Provide information about a patient’s or
resident’s condition to the caller.

Copyright © 2012. Wolters Kluwer Health | Lippincott Williams & Wilkins. Workbook for Lippincott’s Textbook for Nursing Assistants,
A Humanistic Approach to Caregiving, 3rd edition.
LWBK743-Ch05_20-24.qxd 11/8/10 9:31 AM Page 23 Aptara

CHAPTER 5 COMMUNICATION SKILLS 23

4. To relay vital information about a patient’s Activity J Think About It! Briefly answer the
or resident’s condition to a nurse following question in the space provided.
5. To report and record information in a What legal document is used to record informa-
health care unit tion about a person’s current condition, the mea-
sures that have been taken by the medical and
Activity I Match the documents of a medical nursing staff to diagnose and treat the condition,
record given in Column A with their description and the person’s response to the treatment?
in Column B. Write the name of the document in the space
Column A Column B provided below.

1. Admission a. Document used by the

sheet doctor to communicate
to other members of
2. Medical
the health care team
history
what should be done
3. Physician’s for the patient or resi- Activity K Think About It! Briefly answer
order sheet dent the following question in the space provided.

4. Narrative b. Document where You are caring for Mrs. Wilson, who has been ad-
nurse’s information that is mitted to a hospital for the treatment of hyper-
notes gathered routinely, tension. One morning, Mrs. Wilson tells you that
such as vital signs, is she feels dizzy when she gets up from the chair.
5. Graphic recorded This is your subjective observation. What objec-
sheet tive data would you gather to support the subjec-
c. Record of previous
surgeries and medical tive data given to you by Mrs. Wilson?
conditions, current
medications, allergies,
and current medical
diagnosis
d. Provides standard
information about
the patient or resident,
such as his or her
name, address,
age, and insurance
information
e. Record of a patient’s
or resident’s com-
plaints (symptoms)
and the actions taken
by the nursing staff
to address these
complaints

Copyright © 2012. Wolters Kluwer Health | Lippincott Williams & Wilkins. Workbook for Lippincott’s Textbook for Nursing Assistants,
A Humanistic Approach to Caregiving, 3rd edition.
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